A circular stapler is one device that can be used in surgical applications for the joining of body tissue. In the area of surgical anastomotic stapling, it can be used for joining pieces of tissue in a manner such that a continuous pathway, lumen, or surgical opening, is formed after the tissue is stapled together. This lumen is formed when a circular array of staples is used to join two pieces of tissue after which the tissue interior to the innermost circle of staples is cut out by a concentric circular retractable blade. Retraction of the circular stapler removes the cut tissue to form a lumen.
In the art of surgery, it has been known to use purse string sutures and purse string appliers for circular staplers. The suture is typically placed using a needle, staples or other suitable means for attaching the suture to the tissue. After attachment, the ends of the suture remain loose for pulling to contract or close the tissue. Conventional needles and instruments are well known in the art for inserting or attaching purse string sutures to tissue. For example, purse string surgical instruments utilizing needles and toothed jaws are disclosed in U.S. Pat. Nos. 4,345,600; 4,915,107; and 5,188,636. U.S. Pat. Nos. 4,821,939; 5,158,567; and 5,490,856 disclose purse string applicators with stapling cartridges for attaching a suture to tissue and are incorporated herein by reference in their entirety.
Surgical instruments for attaching a purse string can require a relatively high degree of dexterity. Typically, for example, at least one free unattached end portion of the suture is in a loose state, both during and after attachment to tissue. This requires the user of the surgical instrument to either hold or keep track of the unattached end portion. Furthermore, when attempting to pull the purse string to a desired tension, it can be difficult to maintain that tension while attempting other hand movements.
It would therefore be advantageous to provide a purse string instrument having means to hold or retain at least the end portion or portions of the suture during certain surgical procedures.
Additionally, with the advent of minimally invasive, e.g. endoscopic, surgical procedures, it would be advantageous to provide an endoscopic purse string device which could minimally invasively apply purse string sutures. The benefits of minimally invasive surgery, e.g. shorter recovery time, reduced patient trauma, shorter hospital stay, etc. are well known.